Application for Employment
Citywide Family of Companies
 
spacer
Applications are considered for all positions without regard to considerations made unlawful by federal, state, or local laws, such as race, creed, color, religion, sex, national origin, ancestry, age over 40, marital status, physical or mental disability, sexual orientation, medical condition or any other consideration made unlawful by federal, state, or local laws. Citywide is an equal opportunity employer and selects employees on the basis of ability, experience, training, and character.

Please indicate the Citywide company to which you are applying.
Citywide Mortgage Citywide Realty Corp Citywide Insurance
 
PERSONAL APPLICANT INFORMATION
*Indicates required information
 

*First Name

*Middle Name

*Last Name

*Address (line 1)

Address (line 2)

*City

*State, Province, or Region

*Zip or Postal Code

*Country

*Telephone

Telephone2
E-Mail Address

*Social Security Number

*Position Applying For

Salary Expected

Type of Employment
Willing to Work Overtime
Yes No

Referral Source
Ad
 Web Site
 Walk-In
 Employment Agency
 Citywide Employee:   
Other: Please Specify

*Work Permit
If hired and you are under 18, can you furnish a work permit?
 Yes No Over 18, not applicable.

*Previously Worked or Applied For
Have you previously worked for or applied for a position with Citywide?
 Yes No
If yes, please state dates. And, if employed, in what position.
EDUCATION
*High School    Yes No

School Name

Street Address

City

State

Zip or Postal Code

Course of Study

Last Year Completed

Graduated
Yes No

List Diploma
*College          Yes No

School Name

Street Address

City

State

Zip or Postal Code

Course of Study

Last Year Completed

Graduated
Yes No

List Degrees
*Other            Yes No

Institution Name

Street Address

City

State

Zip or Postal Code

Course of Study

Last Year Completed

Graduated
Yes No

List Degree or Certificate
MILITARY SERVICE
Special Skills or Abilities
Have you obtained any special skills or abilities as a result of service in the military?
 Yes No
If yes, please explain.
OTHER QUALIFICATIONS
Special Qualifications
List any special qualifications, knowledge, skills or office equipment/machinery you operate.
EMPLOYMENT HISTORY
*Please list your full-time and part-time employment history starting with your most recent employment under Company #1.
Company #1

*Company Name

*Telephone

*Dates Employed
From To

*Street Address

*City

*State, Province, or Region

*Zip or Postal Code

*Position Held

*Supervisor's Name

*Rate of Pay
Start End

*Job Duties

*Reason for Leaving
Company #2

Company Name

Telephone

Dates Employed
From To

Street Address

City

State, Province, or Region

Zip or Postal Code

Position Held

Supervisor's Name

Rate of Pay
Start End

Job Duties

Reason for Leaving
Company #3

Company Name

Telephone

Dates Employed
From To

Street Address

City

State, Province, or Region

Zip or Postal Code

Position Held

Supervisor's Name

Rate of Pay
Start End

Job Duties

Reason for Leaving
 
EMPLOYMENT DATA
 
NOTE: Please explain any "yes" answer fully so that individual circumstances can be considered. A "yes" answer will not necessarily disqualify you.
 

*Start Work Date
What date would you be available to start work?

*Discharge History
Have you ever been discharged or asked to resign from a position?
Yes No
If yes, please explain.

*Criminal Conviction
Have you ever been convicted of a felony or a misdemeanor?
 Yes No
A conviction does not necessarily disqualify an applicant from employment. Do not include any marijuana-related conviction(s) dated more than two years ago; convictions that have been sealed, expunged, or legally eradicated; and misdemeanor convictions for which probation was completed and the case dismissed.
If yes, list date(s), name of court, case number, and charge(s) of which convicted.
 
Please read carefully before you submit this application.

I request and authorize investigation by Citywide of all statements contained in this application. I understand that falsification (including misrepresentation or omission of facts called for) will result in immediate removal of my application from consideration or immediate discharge from employment arising from this application regardless of when such falsification is discovered. I specifically request, authorize, and consent to Citywide thorough investigation of whether I have a record of criminal convictions and, if so, the nature of such criminal convictions and all surrounding circumstances available through lawful means. Citywide has advised me that its criminal background check will focus on convictions and that a criminal record will not necessarily disqualify me from employment. I request, authorize and consent to the foregoing parties to provide the requested information to Citywide and release them and Citywide from any liability arising therefrom.

I UNDERSTAND AND AGREE THAT:

  1. If hired, I shall preserve in strictest confidence all information concerning the business of Citywide, its customers, and vendors. I understand that signing the Company’s Confidential Information and Inventions Agreement would be material condition of my employment.
     
  2. Employment by Citywide is "at will". Employment at will may be terminated with or without cause and with or without notice at any time by the employee or Citywide.
     
  3. If hired, I must comply with the Immigration Reform and Control Act of 1986. I will complete Form I-9 and provide verification of my legal right to work in the United States.
     
  4. If hired, I agree to conform to the rules and regulations of Citywide.
     
  5. Prior to an offer of employment, a credit report is necessary for individuals being considered for executive and administrative positions, such as certain salaried professional, managers, and executives.
     
  6. Employment is contingent upon passing of post-offer drug screening test and satisfactory background and reference checks. In the event that employment commences before these can be completed, continued employment is subject to a satisfactory outcome of each.
     
  7. Certain positions require a post-offer, job-related physical examination to assess the applicant's job readiness.

This application for employment becomes void after 90 days. You may re-apply for consideration once 90 days has elapsed. The re-application process requires submission of a newly completed Citywide application.
* I Agree I Disagree

*Date (mm/dd/yy)